公立医院绩效评价及障碍度测算研究

Research on Performance Evaluation and Obstacle Degree Measurement of Public Hospitals

利用2012-2016年中国大陆31个省份的数据对公立医院绩效进行评价,并通过测算绩效障碍度来对绩效障碍因素进行诊断。结果表明:采用R聚类-变异系数法构建的评价指标体系更具有科学性、可行性;各省份公立医院的整体绩效水平不高,受医保占比、诊治能力、费用负担和药占比等因素的影响较大。因此,建议从五个方面提高公立医院绩效整体水平:一是加强绩效管理信息技术建设,构建动态绩效评价指标体系;二是加强公立医院激励机制构建,提高公立医院整体绩效水平;三是回归公立医院公益性和可及性,增强公立医院的社会效益;四是优化资源配置,增强公立医院的可持续性;五是提高医疗质量,优化公立医院医疗服务提供。

By making use of the data from 31 provinces in China's Mainland from 2012 to 2016,this paper conducts an evaluation of the performance of public hospitals and makes a diagnosis of the performance barrier factors through measuring the performance barrier degrees. The results show that the evaluation index system constructed by R clustering-variation coefficient method is more scientific and feasible. The overall performance level of public hospitals in each province is not high, and it is largely affected by such factors as the medical insurance coverage, diagnosis and treatment capacity,cost burden and drug proportion, etc.. Therefore, it is recommended to improve the overall performance of public hospitals from the following five aspects: firstly, to strengthen the construction of performance management information technology, and establish a dynamic performance evaluation index system;secondly, to strengthen the incentive mechanism construction of public hospitals, and improve the overall performance level of public hospitals;thirdly, to return to the public welfare and accessibility of public hospitals, and enhance the social benefits of public hospitals;fourthly, to optimize the resource allocation and enhance the sustainability of public hospitals;fifthly, to improve the medical quality and optimize the provision of medical services in public hospitals.